Adcetris
brentuximab vedotin · CD30Conducted on MMAE: Ames and mouse lymphoma negative; rat micronucleus positive (aneugenic)
Kadcyla: genotox, carcinogenicity and repro: done or skipped?
ado-trastuzumab emtansine · HER2
Genotoxicity
Conducted on DM1: Ames negative; rat micronucleus positive (aneugenic/clastogenic); monkey micronucleus inconclusive
“DM1 was positive in an in vivo rat bone marrow micronucleus assay at exposures similar to the mean maximum concentrations of DM1 in patients in clinical trials, which is consistent with its mechanism of action.”
Carcinogenicity
Not conducted (not required, advanced cancer)
“8 Carcinogenicity Not required and not submitted.”
Instead of carcinogenicity
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
Instead of genotoxicity
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
DRG histopathology
Not stated in public reviews
Not reported in the public reviews. Reviewers summarise selectively, so this usually means it wasn't discussed publicly, not that it wasn't studied.
Reproductive & developmental
Not conducted (ICH S9; relied on trastuzumab data and DM1 mechanism); fertility effects from general tox
“Based on these findings and consistent with ICH S9, embryo-fetal developmental toxicity studies were not required for the indicated patient population.”
Safety pharmacology
Dedicated single-dose CV/respiratory telemetry study in female cynomolgus plus in vitro hERG with DM1
“Free DM1 does not inhibit the cardiac slow rectifier current at physiologically relevant concentrations. Trastuzumab emtansine does not cause changes in the monkey ECG but it does cause some elevation in blood pressures.”
Genotox: Ames
DM1: negative in bacterial reverse mutation (Ames) assay
“DM1 was negative in an in vitro bacterial reverse mutation (Ames) assay.”
Genotox: in vitro mammalian
Not conducted (DM1 tested in Ames and in vivo rat assay only)
“The genotoxicity of DM1 was evaluated in a reverse mutation assay with Salmonella strains as well as an in vivo chromosome aberration test performed in rats.”
Genotox: in vivo
DM1: positive (aneugenic or clastogenic) in single-dose rat bone marrow micronucleus assay
“DM1 was aneugenic or clastogenic in an in vivo single-dose rat bone marrow micronucleus assay at exposures that were comparable to mean maximum concentrations of DM1 measured in humans administered trastuzumab emtansine.”
Carcinogenicity model
Not conducted (not required)
“Not required and not submitted.”
Carcinogenicity timing
Not required and not submitted
“Not required and not submitted.”
hERG / QT
DM1: 2.5% hERG inhibition at 29.5 μM; IC50 above highest tested concentration
“As 29.5 μM DM1 caused only 2.5% inhibition, both IC20 and IC50 were estimated to be greater than the tested highest dose.”
Same question, other ADCs
Besponsa
inotuzumab ozogamicin · CD22Conducted: calicheamicin positive in Ames and in vitro micronucleus; ADC clastogenic in mouse micronucleus
Datroway
datopotamab deruxtecan · Trop-2Not conducted with ADC; DXd Ames negative, clastogenic in vitro chromosome aberration and in vivo rat micronucleus
Decnupaz
pivekimab sunirine · CD123Not conducted with ADC (ICH S9); FGN849 positive in Ames TA102, in vitro and in vivo micronucleus
Elahere
mirvetuximab soravtansine · FRαNot conducted with ADC; DM4 and S-methyl-DM4 Ames negative, rat bone marrow micronucleus positive
Emrelis
telisotuzumab vedotin · c-MetNot conducted with ADC; MMAE aneugenic (positive rat micronucleus), Ames and mouse lymphoma negative
Enhertu
fam-trastuzumab deruxtecan · HER2Not conducted with ADC; DXd clastogenic (rat micronucleus, CHL chromosome aberration), Ames negative
Mylotarg
gemtuzumab ozogamicin · CD33Conducted: ADC clastogenic in mouse micronucleus; free calicheamicin DMH mutagenic and clastogenic in vitro
Padcev
enfortumab vedotin · Nectin-4Not conducted with ADC; MMAE Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)
Polivy
polatuzumab vedotin · CD79bNot conducted with ADC; MMAE Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)
Tivdak
tisotumab vedotin · Tissue factorNot conducted with ADC; MMAE: Ames and mouse lymphoma negative, rat micronucleus positive (aneugenic)
Trodelvy
sacituzumab govitecan · Trop-2Not conducted with ADC; SN-38 Ames negative, in vitro micronucleus positive (clastogenic)
Zynlonta
loncastuximab tesirine · CD19Not conducted with ADC; SG3199 clastogenic in vitro (micronucleus, chromosome aberration); Ames not assessable (cytotoxicity)